Provider Demographics
NPI:1831785724
Name:DENTISTS AT SOUTH FRIENDSWOOD PLLC
Entity type:Organization
Organization Name:DENTISTS AT SOUTH FRIENDSWOOD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:EDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-761-9837
Mailing Address - Street 1:6010 WASHINGTON AVE STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-5390
Mailing Address - Country:US
Mailing Address - Phone:315-761-9837
Mailing Address - Fax:
Practice Address - Street 1:699 S FRIENDSWOOD DR STE 108
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-4580
Practice Address - Country:US
Practice Address - Phone:713-869-4535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental